Pathological causes of back pain
Sources of pain
Pain may originate from a number of areas in and around the spine. An acute (sudden)
pain can end up as a chronic (prolonged) condition with recurrent attacks of pain that
increase in frequency and severity. The different sources of pain are:
^ Intervertebral disc
^ Facet joints
^ Sacroiliac joint
Muscles and ligaments
Intervertebral disc
Remember I told you that the factors responsible for back pain can be subdivided into
mechanical and pathological causes. The intervertebral disc is the most common cause
of back pain as far as all pathological conditions are concerned. 85% of all back-pain
sufferers have a demonstrable abnormality of the intervertebral disc.
Tears at the junction of the annulus fibrosus and the back part of the vertebral body lead
to degenerative changes that create a tract for herniation of the nucleus pulposus. Tears
occur at the location that is subject to maximum stress during flexion rotation i.e.
bending forwards and twisting sideways. When you bend forwards and twist to one side
to pick up an object or tie your shoelaces, you are causing
maximum harm to the spine. It can lead to rupture of the
annulus fibrosus and allow the inner nucleus pulposus to
protrude through the ruptured area. The position of forward
flexion plus lateral twist is thus the most common initiator of
low back pain.
of low back pain^common initiator^the most^and twisting is^Forward bending^